Individual
CASEY DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 CERRILLOS RD STE 303, SANTA FE, NM 87507-2694
(505) 257-8554
Mailing address
3600 CERRILLOS RD STE 307, SANTA FE, NM 87507-2694
(520) 909-6264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-09313
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11386533
—
NM
Enumeration date
12/18/2015
Last updated
09/26/2022
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